Pegasystems Delivers PegaCRM Healthcare

CAMBRIDGE, Mass., Aug. 6, 2001 — Pegasystems Inc. (NASDAQ: PEGA) has gone to market with its enhanced healthcare customer relationship management (CRM) offering, PegaCRM Healthcare. Several large healthcare organizations are in production and seeing results from the PegaCRM Healthcare solution.

PegaCRM Healthcare is a product designed for healthcare payer organizations and automates many common member inquiries, supporting contact management, account maintenance and history, sales inquiry, fulfillment and member portal connectivity. In addition to helping increase operational efficiencies and reduce costs, PegaCRM Healthcare can integrate with the rest of the institution's front and back office applications, helping to leverage an organization's legacy systems and investments. Its rules-based foundation means that PegaCRM Healthcare may be easily modified, helping it remain current with the rapid rate of change in business. Scalable and thin client, PegaCRM Healthcare can be used either as a departmental package or as the first step toward a complete enterprise-wide CRM solution.

Add-on modules to PegaCRM Healthcare such as member services and claims exceptions processing give healthcare payer organizations the ability to select and implement the solution that may best meet their business needs. For member services, PegaCRM Healthcare helps large healthcare payer organizations provide better service to their members while also helping to reduce servicing timeframes and improving customer satisfaction. The member services module includes eligibility benefits, referrals and claims features. The back office claims exceptions processing component can stand alone from PegaCRM Healthcare and offers claims payment automation and exception research functions.

PegaCRM Healthcare features and benefits:

  • Interface capabilities can bridge multiple back-end systems and facilitate the bi-directional transfer of real-time customer information leveraging existing technology and helping with time-to-market;
  • Business process automation helps improve productivity and minimizes manual work efforts; the system actually performs tasks, helping to reduce the need for human intervention;
  • Dialogue and scripting features help reduce training time and increase CSR satisfaction;
  • Rules-driven technology empowers business users, not just IT staff, to change the rules that drive application behavior, facilitating rapid response to changing business requirements;
  • Multi-level escalation criteria to drive Service-Level Agreements and help meet regulatory requirements across the enterprise;
  • Optimized work assignment and prioritization facilitates the routing and processing of work according to business needs;
  • Comprehensive auditing and reporting features.

"Healthcare organizations must prepare end users and align and integrate all business processes across their organization or risk not achieving value from CRM investments," stated Joanne Galimi, Senior Analyst, Gartner.

"Healthcare payer organizations are looking to optimize their business processes and collect, package and use their data — including customer-contact data — to the fullest extent despite legacy platform diversity complications and limitations," said Elizabeth Hart, Director of Product Management, Healthcare, Pegasystems. "Today's market forces are causing healthcare payer organizations to shift more of their focus to controlling costs, gaining efficiencies and providing exemplary customer service to members. PegaCRM Healthcare's flexible starter-kit approach enables rapid implementation while providing the personalization and fulfillment capabilities that can give healthcare payer organizations a competitive edge."

Forward-Looking Statements

Certain statements contained in this press release may be construed as "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995. These statements involve various risks and uncertainties which could cause the Company's actual results to differ from those expressed in such forward-looking statements. These risks and uncertainties include the impact of pending regulatory proceedings, difficulty in predicting the completion of product implementations and consequently the timing of revenue recognition, the inability to attract and retain key employees, reliance on key third-party relationships, management of the Company's growth, and other risks and uncertainties. Further information regarding these and other factors which could cause the Company's actual results to differ materially from any forward-looking statements contained in this press release is contained in the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2001 on file with the Securities and Exchange Commission.

About Pegasystems

Pegasystems (NASDAQ: PEGA) develops strategic applications for marketing, sales, service, and operations. Pega’s applications streamline critical business operations, connect enterprises to their customers seamlessly in real-time across channels, and adapt to meet rapidly changing requirements. Pega’s Global 3000 customers include many of the world’s most sophisticated and successful enterprises. Pega’s applications, available in the cloud or on-premises, are built on its unified Pega 7 platform, which uses visual tools to easily extend and change applications to meet clients’ strategic business needs. Pega’s clients report that Pega gives them the fastest time to value, extremely rapid deployment, efficient re-use, and global scale. For more information, please visit us at

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The information contained in this press release is not a commitment, promise, or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described remains at the sole discretion of Pegasystems, Pegasystems specifically disclaims any liability with respect to this information.


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Pegasystems Inc.
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Cambridge, MA 02142
Phone +1 617-374-9600
Fax +1 617-374-9620